2007-02-13 08:18:37 · 3 answers · asked by tutulu 2 in Health ➔ Dental
It would be fraud for a dentist to submit a claim for payment for services, if services were not performed. However, many offices will submit a treatment plan to in order to determine what the insurance will pay, and what the patients responsibility for a particular visit will be. I work for a dentist and have submitted treatment plans for existing patients in order to determine what the copay will be at the next visit, AND I have submitted treatment plans for new patients that have not come in yet, so they too will know what if any copay will be due at their first visit. Its just a tool to help both dentist and patient.
2007-02-13 12:11:22 · answer #1 · answered by yarmiah 4 · 1⤊ 0⤋
If its to get approval thats ok. If it's not it may be a crime. A local Dentist here went to jail on medicaid fraud for billing for procedures he didn't do.
2007-02-13 16:24:30 · answer #2 · answered by sweet sue 6 · 0⤊ 0⤋
If it is a preapproval submission, then yes it is normal if the procedure will be over $500.
2007-02-13 16:22:29 · answer #3 · answered by C C 1 · 0⤊ 0⤋